Record of Support Order Form

This complete form must be submitted to the county's clerk of the court to set up the child support account. (See Texas Family Code §105.008) Note to Clerks: Send the completed form to the State Case Registry/ County Contact Team by fax: 877-924-6872, email: csd-sdu@oag.texas.gov, or mail to TxCSDU, P.O, Box 659400, San Antonio, TX 78265, or use the TXCSES Web Portal to provide this information in lieu of forwarding the document to the TXSDU. In Dallas, El Paso, Harris, Tarrant, Taylor and Travis counties, the completed form must be sent to the Domestic Relations Office.
Order Information
County Name:
Court Number:
Cause Number:
Attorney General Case Number:
Date of Hearing:
Order Sign Date:
Order Type:

New OrderModified Order
Payment Location:

State Disbursement Unit (SDU)Other
By signing below, the party or attorney for the party requests child support services, also called Title IV-D services, for the benefit of the family. (Note: Handwritten or electronic signatures are acceptable.)
Signature

Clear
Date:

MonthDay Year
Date
Typed/printed name:
Signing person's relationship to the case:

Custodial Parent (CP)CP attorneyNon-Custodial Parent (NCP)NCP attorney
Note to Counties: If the document is signed above, and the Record of Support Order information was entered in the TXCSES Web Portal, the document must be forwarded to the Office of the Attorney General by email to csd-fax051@oag.texas.gov or by fax to (512) 781-7206. In counties that forward the Record of Support Order directly to the State Case Registry / County Contact Team, no further action is required. In Dallas, El Paso, Harris, Tarrant, Taylor and Travis counties, the document must be forwarded to the Domestic Relations Office.
Obligee/ Payee/ Custodial Parent Information
Family Violence Protection (FV) (Check if individual below is a victim of family violence)

Family Violence Protection (FV)
Name:*

First Name Last Name
Date of Birth:

MonthDay Year
Date
Social Security Number:
Address:

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Sex:

MaleFemale
Driver's License Number:
Home Phone Number:

Area Code Phone Number
Work Phone Number:

Area Code Phone Number
Cell Phone Number:

Area Code Phone Number
Email:*
example@example.com
Relationship to the Child(ren):
Employer Name:
Employer Address:

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Obligor/ Payor/ Non-Custodial Parent Information
Family Violence Protection (FV)

(Check if individual below is a victim of family violence)
Name:*

First Name Last Name
Date of Birth:

MonthDay Year
Date
Social Security Number:
Address:

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Sex:

MaleFemale
Driver's License Number:
Home Phone Number:

Area Code Phone Number
Work Phone Number:

Area Code Phone Number
Cell Phone Number:

Area Code Phone Number
Email:
example@example.com
Employer Name:
Employer Address:

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Dependent Information
Family Violence Protection (FV)

(Check if dependent below is a victim of family violence)
Name:

First Name Last Name
Sex:

MaleFemale
Date of Birth:

MonthDay Year
Date
Social Security Number:
Family Violence Protection (FV)

(Check if dependent below is a victim of family violence)
Name:

First Name Last Name
Sex:

MaleFemale
Date of Birth:

MonthDay Year
Date
Social Security Number:
Family Violence Protection (FV)

(Check if dependent below is a victim of family violence)
Name:

First Name Last Name
Sex:

MaleFemale
Date of Birth:

MonthDay Year
Date
Social Security Number:
Family Violence Protection (FV)

(Check if dependent below is a victim of family violence)
Name:

First Name Last Name
Sex:

MaleFemale
Date of Birth:

MonthDay Year
Date
Social Security Number:
If there are more children, attach an additional page listing the above information for each additional child.

Browse Files
Additional Child(ren) file Cancelof
Attorney Information
Obligee Attorney:
Phone Number:

Area Code Phone Number
Obligor Attorney:
Phone Number:

Area Code Phone Number
Prepared by:
Phone Number:

Area Code Phone Number
Date:

MonthDay Year
Date of Submission
County Name:
Court Number:
Cause Number:
Should be Empty:

Order Information

Obligee/ Payee/ Custodial Parent Information

Obligor/ Payor/ Non-Custodial Parent Information

Dependent Information

Attorney Information